夜间睡眠时长与抑郁症状的相关性及其调节因素的 探索
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福建省卫生健康科技计划项目( 2024QNB026)


Association and moderating factors between nighttime sleep duration and depressive symptoms
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    摘要:

    目的 探索睡眠时长与抑郁之间的关系,并进一步分析炎症指标、社会人口学特征及生 活方式在两者之间的调节作用。方法 基于美国国家健康和营养调查(NHANES)横断面公开数据库, 排除孕妇、人口学资料不全以及缺少抑郁、睡眠时长、体力活动问卷评估和炎症因子检测的研究对象, 最终共有22 201 人纳入分析。采用多因素Logistic 回归分析与限制性立方样条图分析睡眠时长与抑郁 的关系,深入探讨不同人口学特征、生活方式及炎症指标多维度因素在睡眠时长与抑郁症状之间的调 节作用,并进行亚组间的相乘交互作用分析。结果 在22 201 人中,具有抑郁症状(患者健康问卷-9, PHQ-9 评分≥ 10 分)的有1 909 人,抑郁的阳性检出率为8.6%。多因素Logistic 回归分析与限制性立方 样条图结果显示睡眠时长与抑郁评分呈U 型关系,睡眠不足(OR=1.76,95%CI:1.52~2.03)和睡眠延长 (OR=1.63,95%CI:1.41~1.88)均与抑郁症状风险增加相关(P< 0.05);相乘交互作用分析显示,年龄与 睡眠时长在抑郁中存在交互作用(F=3.389,P交互=0.041),此外,吸烟情况、体重指数、体力活动水平、家庭 收入与贫困比和血小板/ 淋巴细胞比值在睡眠时长与抑郁之间具有调节作用(P交互< 0.05)。结论 睡眠 不足和延长均会增加抑郁风险,特别是在老年人、炎症水平高、戒烟、体力活动水平低、高收入的群体更 为明显。睡眠健康管理应纳入抑郁防治策略,保证正常的睡眠时长有助于降低抑郁的发生风险。

    Abstract:

    Objective To explore the relationship between sleep duration and depressive disorder, and further analyze the moderating effects of inflammatory markers, sociodemographic characteristics, and lifestyle factors. Methods Based on the publicly available cross-sectional database of the National Health and Nutrition Examination Survey( NHANES), after excluding pregnant women, participants with incomplete demographic data, and those lacking questionnaire assessments of depressive disorder, sleep duration, and physical activity or inflammatory marker tests, a total of 22 201 participants were ultimately included in the analysis. Multivariate Logistic regression and restricted cubic spline were used to analyze the association between sleep duration and depressive disorder, This study delved into the moderating effects of multidimensional factors such as demographic characteristics, lifestyle factors, and inflammatory indicators on the relationship between sleep duration and depressive symptoms and to examine multiplicative interactions across subgroups. Results Of the 22 201 study participants, 1 909 exhibited depressive symptoms( PHQ-9 score ≥ 10), resulting in a positive detection rate of 8.6%. Multivariate Logistic regression and restricted cubic spline analysis revealed a U-shaped relationship between sleep duration and depression scores. Both insufficient sleep[ OR=1.76, 95%CI (1.52,2.03)]and excessive sleep[ OR=1.63, 95%CI( 1.41,1.88)]were associated with an increased risk of depressive disorder, and these differences were statistically significant( P < 0.05). Multiplicative interaction analysis revealed a statistically significant interaction between age and sleep duration in relation to depressive disorder( F=3.389, Pinteraction=0.041). In addition, smoking, body mass index, physical activity, poverty income ratio, and platelet-to-lymphocyte ratio exerted moderating effects on the association between sleep duration and depressive disorder, with statistically significant differences( Pinteraction < 0.05). Conclusions Both insufficient and excessive sleep increase the risk of depressive disorder, particularly among older adults, individuals with high levels of inflammation, those who quit smoking, those with low levels of physical activity and high-income. Sleep health management should be incorporated into depressive disorder prevention and treatment strategies, as ensuring adequate sleep duration helps reduce the risk of depressive disorder.

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  • 在线发布日期: 2026-05-19